Indiana University-Purdue University Indianapolis (IUPUI) / Between 1 million and 2.2 million nursing home residents are transferred to a
hospital emergency department each year. These transfers are costly, have negative
health outcomes, and can increase the morbidity and mortality of residents. Few studies,
however, have provided in-depth descriptions of transfer experiences. The purpose of this
study was to examine the transfer process between the nursing home and the hospital
from the perspectives of nursing home residents and nurses, focusing on how decisions
were made to transfer residents. Using a qualitative descriptive method, 22 participants
(10 residents and 12 nurses) were recruited from four nursing homes located in rural
Indiana. Purposive sampling, semi-structured interviews, and conventional content
analysis were used to collect and analyze narratives obtained from residents and nurses
about their experiences with a recent transfer and to develop four in-depth case
descriptions of these transfers. The participants described four aspects of the transfer
process: transfer decisions, transport experiences, hospital stays, and returns to the
nursing home. The most common reason for transfers was an acute exacerbation of a
chronic condition, and the decision to transfer was often made by a nurse. Most
participants found aspects of the transfer, including their hospital stay, to be aversive or
upsetting. The return to the nursing home was typically welcomed but often challenging
due to problems with mobility, medication adjustments, and cognitive changes.
Participants also provided several recommendations for avoiding potentially preventable
transfers including adding “in-house” diagnostic testing and treatment equipment, improving staff competencies in managing acute exacerbations, increasing staffing,
improving communication among staff, and increasing staff familiarity with resident
histories and preferences. The findings have several clinical and policy implications for
preventing or decreasing the negative effects of hospital transfers.
| Identifer | oai:union.ndltd.org:IUPUI/oai:scholarworks.iupui.edu:1805/29297 |
| Date | 05 1900 |
| Creators | Ahmetovic, Alma |
| Contributors | Hickman, Susan E., Draucker, Claire Burke, Huber, Lesa, Unroe, Kathleen T. |
| Source Sets | Indiana University-Purdue University Indianapolis |
| Language | en_US |
| Detected Language | English |
| Type | Dissertation |
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